Feature story

UNHCR: Countering stigma and silence about HIV among refugees and host communities in northern Ecuador

04 March 2011

A version of this story was first published at UNHCR.org

Lucilda, a young mother of two, recently discovered that her husband had infected her with HIV. He recently died and the Colombian refugee finds herself alone in an area where people living with HIV are stigmatized.
Credit: UNAIDS/V. Rodas

Ten years ago, a teenager called Lucilda* ran away from her home in Colombia because she feared her mother's rage after going to a party without permission. At the age of 25 she got married and fled to Ecuador with her husband to escape the conflict in southern Colombia's Putumayo department. Her husband was violent to her and unfaithful. He has since died of an AIDS-related illness and Lucilda is struggling to raise two children alone as a refugee in Ecuador.

"He was very ill, but he didn't want to go to see a doctor. I took him and they told us what was going on. They also said that I was infected," she added. "He knew that he had AIDS, but he never told me."

Lucilda is receiving antiretroviral treatment and both her children are HIV negative. She is one of a small, but growing, number of people living with HIV in northern Ecuador's Sucumbios province and its capital, Lago Agrio, where some 20% of the population of 60,000 are Colombian refugees. At least 30 people here were known to be living with HIV as of the end of last year, double the number for 2009.

"This figure is certainly just the tip of the iceberg with regard to the number of people who are infected with HIV," said Paul Speigel, head of UNHCR's Geneva-based Public Health and HIV Section.

But the lack of openness about HIV is difficult to tackle in a conservative, male-dominated society, where those living with HIV, especially women, face stigmatization. With understanding key to preventing new infections, UNHCR and its partners are trying to counter this mindset and to spread awareness about the virus.

I didn't want him to touch me, but he took a knife and forced me

Lucilda,* a woman living with HIV who is a refugee in Ecuador

A special UNHCR programme to prevent HIV has been implemented by community health workers, and is helping to educate refugees and host communities in isolated areas of the jungle surrounding Lago Agrio. They also give lessons on sexual health, family planning and general health services, explaining the importance of safe sex and ensuring that people have the knowledge and freedom to keep themselves safe from HIV. Tackling gender-based violence is also a major concern in attempts to halt the spread of HIV.

Lucilda has firsthand experience of such violence. When she found out that her husband had been having sex with other women his reaction was harsh.

"I didn't want him to touch me, but he took a knife and forced me," she recalled. "I felt as if I had been raped."

The new UNAIDS strategy 2011-15, promotes zero tolerance of gender-based violence and discrimination. It recognizes that such violence is a human rights violation. It can also hamper people’s ability to adequately protect themselves from HIV infection and make healthy decisions about how, when and with whom they have sex. To successfully challenge the AIDS epidemic it is seen to be of paramount importance that Lucilda and other women live their lives free from the threat of violence.  

*Name has been changed to protect her identity